Yu Dangfan, Du Kaiqi, Liu Taifeng, Chen Guojun
Department of Nuclear Medicine, Zhejiang Provincial Corps Hospital, Chinese People's Armed Police Force, Jiaxing 314000, China.
Int J Mol Sci. 2013 May 27;14(6):11145-56. doi: 10.3390/ijms140611145.
The aim of this study was to investigate the prognostic value of tumor markers in operable non-small cell lung cancer (NSCLC) patients. A total of 481 NSCLC patients were enrolled in the present study. High levels of neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125) and squamous cell carcinoma antigen (SCC) were detected in 306 (63.6%), 89 (18.5%) and 125 (26.0%) patients, respectively. Seventy-eight of 481 patients died of disease progression, and the median disease-free survival (DFS) and overall survival (OS) were 16.0 and 21.0 months, respectively. The three-year DFS rate was 56.7%, and the OS rate was 75.3%. For serum NSE, the three-year cumulative DFS rate for the normal and elevated group was 67.7% and 51.8% (p = 0.007). The OS in patients with high and normal levels of NSE was 34.0 months and 48.0 months, respectively. The median DFS was 46.0 months versus 32.0 months (p = 0.001), and the OS was 48.0 months versus 44.0 months (p = 0.001) in patients with normal and high levels of CA125. For patients with squamous cell carcinoma, the overall survival was significantly shorter in patients with elevated levels of SCC (p = 0.041). In the multivariate analysis high levels of NSE, CA125 and clinical stage were significantly correlated with worse prognosis (p < 0.05). Patients with all three tumor markers elevated presented the worst prognosis (p < 0.05). In our analysis, high levels of preoperative serum NSE and CA125 are correlated with worse survival in operable NSCLC patients.
本研究旨在探讨肿瘤标志物在可手术切除的非小细胞肺癌(NSCLC)患者中的预后价值。本研究共纳入481例NSCLC患者。分别在306例(63.6%)、89例(18.5%)和125例(26.0%)患者中检测到高水平的神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)和鳞状细胞癌抗原(SCC)。481例患者中有78例死于疾病进展,无病生存期(DFS)和总生存期(OS)的中位数分别为16.0个月和21.0个月。三年DFS率为56.7%,OS率为75.3%。对于血清NSE,正常组和升高组的三年累积DFS率分别为67.7%和51.8%(p = 0.007)。NSE水平高和正常的患者的OS分别为34.0个月和48.0个月。CA125水平正常和高的患者的DFS中位数分别为46.0个月和32.0个月(p = 0.001),OS分别为48.0个月和44.0个月(p = 0.001)。对于鳞状细胞癌患者,SCC水平升高的患者的总生存期明显较短(p = 0.041)。在多变量分析中,高水平的NSE、CA125和临床分期与较差的预后显著相关(p < 0.05)。三种肿瘤标志物均升高的患者预后最差(p < 0.05)。在我们的分析中,术前血清NSE和CA125水平高与可手术切除的NSCLC患者的较差生存相关。